Inpatient Psychodynamic Psychotherapy Research Articles

Emotional experience and change in psychodynamic inpatient psychotherapy

Emotional experience and change in psychodynamic inpatient psychotherapy Objectives: The subject of the present study is the recording of emotional experience and its change through inpatient psychodynamic psychotherapy, taking into account the factors of age, gender, and traumatic experiences in childhood and adolescence. Methods: The following standardized instruments were used on the clinical sample of 971 patients (413 inpatient, 558 day clinic patients) at the beginning and at the end of the treatment: Questionnaire for the Assessment of Emotional Experience and Emotion Regulation (EER), Childhood-Trauma-Questionnaire (CTQ), Inventory of Interpersonal Problems (IIP), Helping Alliance Questionnaire (HAQ), Symptom-Check-List (SCL-90-R). Results: The mean duration of treatment was 66.8 days (SD = 14.1; range 30-96). Younger patients and polytraumatized patients showed a higher expression of negative emotions. At the end of treatment, the whole group of patients showed a change in emotional experience, especially a strong decrease in passive-negative emotions and a decrease in psychological distress. Age represented a significant factor influencing emotional change. Discussion: The results underline the importance of emotional change as a prerequisite for treatment success and confirm the effectiveness of inpatient psychodynamic treatment. A further differentiation of the patients with regard to their emotional responsiveness seems to make sense with regard to the suitability of the therapeutic offers.

Defense Mechanisms and Treatment Response in Depressed Inpatients.

The study investigated the extent to which defensive functioning and defense mechanisms predict clinically meaningful symptomatic improvement within brief psychodynamic psychotherapy for recurrent and chronic depression in an inpatient setting. Treatment response was defined as a reduction in symptom severity of 46% or higher from the baseline score on the Montgomery–Asberg Depression Rating Scale (MADRS). A subsample of 41 patients (19 responders and 22 non-responders) from an RCT was included. For each case, two sessions (the second and the penultimate) of brief inpatient psychodynamic psychotherapy (a manualized 12-session therapy program developed in Lausanne) were transcribed and then coded using the Defense Mechanism Rating Scales (DMRS) and the Psychotic Defense Mechanism Rating Scales (P-DMRS), an additional scale developed to study psychotic defenses. Results showed that defensive functioning and mature and immature defense changed during psychotherapy and predicted treatment response. Patient’s defenses observed throughout therapy also predicted treatment response at 12-month follow-up. The addition of psychotic defenses allows a better prediction of the treatment response. Overall, these results are in line with previous research and provide further validation of defensive functioning as a predictor of outcomes and a mechanism of change in psychotherapy.

Long-Term Patterns of Depressive Symptomload and their Predictors in Hospitalised Patients Undergoing Psychodynamic Psychotherapy: Findings of the STOP-D Study

Depression is one of the most common mental disorders. While the general effectiveness of in- and outpatient psychotherapy is proven, different long-term patterns in treatment of symptoms of depression have been described. The aim of the present study was to show different patterns of benefit in the context of inpatient psychodynamic psychotherapy of depressive disorders and to detect predictors of different types of response that help to identify possible non-responders and adjust treatments accordingly. Data of the naturalistic multicentre intervention study were collected in 15 German psychosomatic hospital units employing a predominantly psychodynamic approach to treatment. The sample includes n=432 patients (women: age 25-45 years) with typical symptoms of depression. The patterns of outcome were identified using a latent state model with a method factor and a latent class analysis; potential course predictors were analysed using regression analysis. Three long-term patterns of outcome were identified: patients with significant treatment benefit, whose symptom decline was stable even in a 6-month catamnesis (Responders: 76.9%), patients without a significant symptom decrease during treatment and in the follow-up survey (Non-responders: 18.8%), as well as patients with a significant symptom decrease but showing an increase of symptoms in the catamnesis (Backsliders: 4.4%). The severity of baseline depressive symptom load was determined as a predictor for the pattern of Backsliders. Non-responders differed from responders in having had psychosomatic pre-treatments more frequently. In the case of backsliders, further studies should, for instance, verify whether relapses can be explained by the patient's symptoms, treatment, or social environment. In the case of non-response due to numerous unsuccessful pre-treatments, the question arises whether psychosomatic treatment offers the right setting for these patients or how therapy settings should be modified. Long-term patterns reported in the literature were partially confirmed. There are indications of an influence of the initial symptom-load severity on the outcome of treatment. It is important to consider how treatment settings can be modified accordingly.

Long-term effectiveness of psychodynamic inpatient therapy on depressive disorders - Catamnestic- Results of the STOP-D-Study

Long-term effectiveness of psychodynamic inpatient therapy on depressive disorders - Catamnestic- Results of the STOP-D-Study Objectives: Depression is one of the most common disorders with a rate of recurrence between 60-75 %. The effectiveness of psychodynamic therapy is well-proven, but there is still a lack of studies proving the long-term effectiveness of inpatient treatment on depressive symptom load. Methods: After psychodynamic inpatient treatment in a psychodynamically oriented psychosomatic hospital unit, the reduction in general and depressive symptom load (e. g. BDI, HAMD, SCL-90-R) was evaluated by a six-month follow up design. The study was set up as naturalistic multicenter intervention study including a female follow-up sample (N = 291; age 25-45 years). Results: The symptom improvement reached by the inpatient treatment remained stable at the follow-up survey. Patients treated with antidepressant medication showed stronger depressive symptom load at discharge and follow-up survey compared to patients without antidepressant medication. Sociodemographic variables and a comorbid personality disorder were not associated with increased drop-out rates, but depressive symptom load and a premature ending of the treatment. Conclusions: The obtained results demonstrate the long-term effectiveness of inpatient psychodynamic psychotherapy. Further studies about the influence of post-hospital psychotherapy and medical treatment as well as patient satisfaction seem necessary.

Changes in the scales "attachment" and "control" of the OPD-KJ "structure" axis for inpatients of a pediatric and adolescent psychiatric clinic

Changes in the scales "attachment" and "control" of the OPD-KJ "structure" axis for inpatients of a pediatric and adolescent psychiatric clinic Abstract. Abstracts: Despite the great importance of structural deficits in adolescent patients, studies on changes that occur in the course of their inpatient psychiatric treatment are lacking. This study assesses the effectiveness of inpatient psychodynamic psychotherapy, the scales "attachment" and "control" of the "structure" axis of Operationalized Psychodynamic Diagnostics in Childhood and Adolescence (OPD-KJ). The study was carried out by dual case leaders (psychotherapist and pedagogue/nurse) on 75 patients (12-18 years) at the beginning and at end of 8 weeks of therapy. Correlations between the dimensions were investigated Pearson's r. Subsequently, we analyzed the four subdimensions of control and attachment using analyses of variance with repeated measurement (RM-ANOVA) to determine whether and to what extent these different subdimensions changed over time. Finally, we performed analyses of variance with age, sex, and diagnosis as between-person factors to assess their influence on the trajectories of both dimensions. Results show that both the attachment and the control dimension of OPD-CA improved in the course of the adolescents' treatment. This finding, however, was diagnosis-specific: Only adolescents with affective disorders and phobias showed these improvements, whereas no change was found for adolescents with emotional and behavioral disorders beginning in childhood and adolescence. Implications for research and clinical practice are discussed.

Perceived Psychotherapist's Empathy and Therapy Motivation as Determinants of Long-Term Therapy Success-Results of a Cohort Study of Short Term Psychodynamic Inpatient Psychotherapy.

Objective: Outcome predictors and determinants for treatment outcome of inpatient psychotherapy will be assessed in a follow-up-study. Sociodemographic factors and the level of depressiveness at admission, the perceived psychotherapist's empathy rated by patients and the therapy motivation as possible moderators of treatment outcome (reduction of depressive symptoms) are analyzed.Methods: In a cohort study, the outcome of inpatient multimodal psychotherapy was examined with Beck-Depression-Inventory (BDI) at admission (T1), discharge (T2) and at follow-up (1–3 years after treatment) (T3). Inclusion criteria were: Inpatient psychotherapy between 2007 and 2010 with a duration of at least 1 week and complete data set. The influence on therapy success of (1) sociodemographic factors, (2) the perceived psychotherapist's empathy rated by patients using the Consultation and Relational Empathy Measure (CARE), and (3) the therapy motivation of the patients rated by therapists are examined by means of correlation analysis, distribution comparisons and subsequently logistic regression.Results: Ninety-two (64 females, average age 39 yrs.) of 182 eligible patients participated in the follow-up survey. Duration of inpatient psychotherapy lasted 8.7 weeks ± 3.6 [min. 1, max. 33 weeks]. The perceived psychotherapist's empathy, therapy motivation, education level and depression at baseline had a significant impact on therapy success. Gender, age, and partnership were not significant. The length between discharge and follow-up had no influence on the results. Based on these variables a multiple logistic regression explained 42% of the variation (goodness-of-fit).Conclusion: Due to the shown relevance of the psychotherapist's empathy perceived by patients and the therapy motivation of patients for therapy success, both factors should be considered already at the beginning of the therapy. Consequently, they should be recognized in the context of postgraduate training and education.

Operationalized Psychodynamic Diagnosis System and Outcome of Psychodynamic Inpatient Psychotherapy in Male and Female Patients

To compare male and female patients with regard to the Operationalized Psychodynamic Diagnosis (OPD-2) system, treatment variables, and outcome after multimodal psychodynamic inpatient psychotherapy. At the beginning and at the end of inpatient treatment in a multimodal psychodynamic setting, patients were examined with the OPD-2 systemas well as with three self-assessment questionnaires addressing interpersonal problems (Inventory of Interpersonal Problems, IIP), and psychopathology: Brief SymptomInventory (BSI) and the Hospital Anxiety and Depression Scale (HADS). Data of 850 patients (238 males, 28%), 612 females, 72%) were available for analysis. There were differences between men and women in the main diagnoses, with a higher proportion of eating disorders and a longer treatment duration among the women. Therapy discontinuation rates were low and did not differ between the sexes. Women scored higher on psychopathology at admission on the BSIGlobal Score, IIP and anxiety; the pattern of reported interpersonal problems was consistent with sex roles. While the level of structural integration was similar in both sexes, the distribution of the two main conflicts and the level of improvement of awareness and dealing with the psychodynamic foci showed significant differences. Overall, at the end of inpatient psychotherapy, there was a mean improvement in both men and women, with no significant differences between them. Because of higher scores at the start of psychotherapy, the effect sizes for improvement were higher for women. On the whole, both sexes seem to benefit equally from psychodynamic inpatient psychotherapy in terms of symptom improvement.

Online Self-Help as an Add-On to Inpatient Psychotherapy: Efficacy of a New Blended Treatment Approach

Background: Depression is one of the most frequent and costly mental disorders. While there is increasing evidence for the efficacy of online self-help to improve depression or prevent relapse, there is little evidence in blended care settings, especially combined with inpatient face-to-face psychotherapy. Therefore, we evaluated whether an evidence-based online self-help program improves the efficacy of inpatient psychotherapy. Methods: A total of 229 depressed patients were randomly allocated either to an online self-help program (intervention group [IG]; Deprexis) or an active control group (CG; weekly online information on depression) in addition to inpatient psychodynamic psychotherapy. Both groups had access to their respective experimental intervention for 12 weeks, regardless of inpatient treatment duration. Reduction of depressive symptoms, as measured with the Beck Depression Inventory-II, was the primary outcome at the end of the intervention (T2). Results: Depressive symptoms were statistically significantly lower in the IG compared to the active CG at T2 with a moderate between-group effect size of d = 0.44. The same applied to anxiety (d = 0.33), quality of life (d = 0.34), and self-esteem (d = 0.38) at discharge from inpatient treatment (T1). No statistically significant differences were found regarding dysfunctional attitudes (d = 0.14) and work ability (d = 0.08) at T1. Conclusions: This is the first evidence for blended treatment combining online self-help with inpatient psychotherapy. The study opens new and promising avenues for increasing the efficacy of inpatient psychotherapy. Future studies should determine how integration of online self-help into the therapeutic process can be developed further.

Psychoanalytic inpatient psychotherapy of depression – Two naturalistic samples throughout the course of a decade

Background: While the general effectiveness of psychodynamic inpatient psychotherapy has been established, very few studies have specifically investigated the effectiveness of psychodynamic inpatient treatment of depression, though depressed patients represent the largest group of inpatients.Method : This study investigated two naturalistic samples of depressed patients regarding treatment outcome as well as clinical and treatment characteristics. Patients were treated in a psychoanalytical psychosomatic hospital unit. Data was collected from 2000 to 2002 (N=234) and from 2008 to 2010 (N=514). Data was acquired at admission and discharge.Results: The findings reveal high pre-post effect sizes for symptom reduction (SCL-90-R), general functioning (GAF) and medium changes of interpersonal problems (IIP). The improvement on the IIP was significantly higher for patients with comorbid personality disorder. Based on therapist ratings, the sample treated from 2008-2010 showed higher levels of impairment on several levels: chronic, complex, functional (GAF) and structural (OPD).Conclusion: Findings indicate that patients show substantial short-term benefit following psychoanalytic inpatient psychotherapy, as practiced under naturalistic conditions. Open questions remain regarding the long-term nature of these benefits and the possible influence of placebo-effects.

Depression and Comorbid Personality Disorder - Effectiveness of Psychodynamic Inpatient Psychotherapy

Objectives Depression is one of the most common illnesses. The effectiveness of psychodynamic psychotherapy on depressive symptom load has been demonstrated. However, for patients suffering from comorbid personality disorder (PD) a decreased benefit has been reported, as well as fewer rates of remission and extended duration of remission. However, findings are inconsistent. The objective of this study was to determine potential differences in therapy-outcome comparing female patients with and without comorbid PD. Method Including female inpatients aged between 25-45 years (N=377) in a psychodynamic treatment, the dissenting outcome on depressive symptom load (among others BDI; HAMD) as well as psychodynamic variables (IPO) by patients with and without comorbid PD were analysed within a naturalistic multicenter intervention study (STOP-D). Data were collected in 15 psychodynamically oriented psychosomatic hospital units in Germany, based on self- and external-assessment instruments. Results Under comparable therapy-doses, female patients with and without comorbid PD benefit significantly from psychodynamic inpatient treatment. By equivalent baseline severity of clinical symptoms patients without comorbid PD show larger effect sizes in all inventories than patients with comorbid PD. Discussion Although the benefit is lower for depressed patients with comorbid personality disorder, the positive effect of inpatient psychodynamic psychotherapy is statistically and clinically significant in both groups. Influences of further comorbid symptoms and confounding symptoms between depression and PD, which were difficult to control, are possible. Further studies are necessary. Conclusion Although patients with comorbid PD benefit significantly from the inpatient treatment, a special therapeutic design seems to be indicated for these patients.

Was macht stationäre Psychotherapie erfolgreich? Der Einfluss von Patienten- und Behandlungsmerkmalen auf den Therapieerfolg in der stationären Psychotherapie

This study investigates the symptomatic and interpersonal efficacy of inpatient psychodynamic psychotherapy as well as the influence of several patient- and treatment-related factors on the success of psychotherapy. In this naturalistic study, 715 patients were assessed with the Symptom Checklist (SCL-90-R) and the Inventory of Interpersonal Problems (IIP). The influence of several patient-and treatment-related factors on the success of psychotherapy was analyzed using logistic regression. Patients improved significantly on all SCL-90-R and IIP scales. The patients' attachment style, ICD-10 diagnosis, and motivation for therapy, as well as additionally job situation for the symptomatic outcome and additionally age for the interpersonal outcome, were significant predictors of therapeutic success. Patients with a secure attachment style, a diagnosis of depression, and a high motivation for therapy are more likely to experience therapeutic success than other patients. Furthermore, regular occupational activity has a positive effect on symptomatic treatment outcome, while a younger age has a positive effect on interpersonal treatment outcome.

Evaluation of inpatient psychodynamic psychotherapy for adolescents who suffer from mixed disorders of conduct and emotions (F92, ICD-10) with OPD-CA axis structure

Evaluation of inpatient psychodynamic psychotherapy for adolescents who suffer from mixed disorders of conduct and emotions (F92, ICD-10) with OPD-CA axis structure

Langzeit-Katamnese zur Effektivität einer stationären psychodynamischen Psychotherapie

This study investigates the stability of symptomatic and interpersonal changes after inpatient psychodynamic psychotherapy. 437 patients were assessed 3 to 5 years after discharge with the Symptom Checklist (SCL-90-R), the Inventory of Interpersonal Problems (IIP), global assessment of effectiveness and utilization of posttreatment psychotherapy. The therapist's perspective was evaluated by the Impairment Severity Score (BSS), the Global Assessment of Functioning Scale (GAF), and the Clinical Global Impressions (CGI). Patients improved in all SCL-90-R scales significantly. The Global Severity Index (GSI) effect size was 0.81 posttreatment and 0.82 at follow-up. All IIP scales improved significantly; effect size of IIP total score was 0.40 at posttreatment and 0.60 at follow-up. There were substantial gains in BSS,GAF, and CGI. 84% of the patients were in psychotherapy after dismissal. Posttreatment results were in accordance with comparable studies. The results are stable on a symptomatic level and improve further on an interpersonal level.

From symptom relief to interpersonal change: Treatment outcome and effectiveness in inpatient psychotherapy

This study evaluated the impact of psychodynamic inpatient psychotherapy on patients’ psychological distress and interpersonal problems during the course of treatment and 1 year later. A total of 156 patients were assessed with the Symptom Checklist-90-Revised and the Inventory of Interpersonal Problems at intake, 4 weeks later, and at the end of therapy. The follow-up assessment was conducted 1 year later. Results support psychodynamic approaches as well as the phase model, which stresses that the goals to be achieved by psychotherapeutic interventions are not only improvement of well-being and symptoms but also changes in interpersonal behavior. Consequently, on a long-term basis, the first 4 weeks of therapy seem to be insufficient, especially for adequate changes on the interpersonal level.

Fokusorientierte Interventionen mit der OPD in der stationären Psychotherapie: Effekte auf Ergebnis und Verlauf der Behandlung

The study explores the course and outcome of inpatient psychodynamic psychotherapy (N=200) with particular regard to interpersonal experiences and behaviour. Based on the implementation of a focus conference, the multi-professional team members formulated an interpersonal treatment focus and individualised helpful interpersonal attitude towards the patient (so-called therapeutic tuning). This focus formulation follows the systematic procedure provided by the Operationalised Psychodynamic Diagnostics System (OPD-2). The study was initiated to evaluate the effectiveness of the so-called "tuning-treatment" compared to inpatient "treatment as usual". Compared to "treatment as usual", the tuning condition showed greater improvement (p>.001) in interpersonal functioning (GARF). Interpersonal problems (IIP) and symptoms (SCL-90-R) were slightly more improved than in the "treatment as usual" cases (p=.13 and. p=.09). An interpersonal treatment focus followed by focus-oriented interventions is a promising approach for inpatient psychodynamic psychotherapy. Generalisation of the empirical results is, however, limited due to problems of internal validity.

Einfluss von Persönlichkeitsmerkmalen auf die erlebte Hilfe und Belastung durch Gruppentherapie und Mitpatienten in der stationären psychodynamischen Psychotherapie

The aim of the study was to investigate whether dimensional traits of personality disorder and other aspects of personality had an influence on perceived help and stress by the subsettings of a multimodal psychodynamic inpatient psychotherapy. 89 patients of a psychodynamic psychotherapy clinic were investigated. Symptom severity was measured using SCL-R-90 symptom check list and BSS (Impairment Score). A questionnaire for patients' assessment of perceived help and stress by each subsetting of the therapy program was administered weekly. Personality assessment included (1) personality traits related to specific personality disorder as defined by SCID-II interview and questionnaire, (2) interpersonal problems as measured by the IIP, (3) self-related affiliation as measured by SASB-INTREX questionnaire (Introjekt), and (4) psychotrauma as determined by the Childhood Trauma Questionnaire (CTQ). Therapy outcome measures were: change of SCL-90-R, change of BSS, perceived change in VEV. Perceived help and stress by the total setting, by inpatient group therapy and by fellow patients were shown to be primarily influenced by personality traits related to DSM-IV clusters of personality disorders, particularly by Cluster-A-related traits. Interpersonal dominance and trauma history had an influence as well. Perceived help and stress by subsettings of inpatient psychotherapy can be predicted on the basis of several aspects of personality.

Entspricht die Symptombesserung vier Wochen nach Behandlungsbeginn dem Erfolg in der Ein-Jahres-Katamnese?

This study was conducted to explore differentiated aspects of outcome throughout and one year after psychodynamic inpatient psychotherapy with special regard to symptomatic distress and interpersonal behaviour. Sixty-four patients of the Department of Psychotherapeutic Medicine of the Jerichow Hospital (Saxonia-Anhaltina) were investigated with the SCL-90-R and the IIP-D four times: at the beginning of inpatient psychotherapy (t0), four weeks after (t1), at the end (t2), and one year after discharge (t3). The improvement of symptoms four weeks after the beginning of psychodynamic inpatient psychotherapy is equivalent with long term outcome. The Global Severity Index of SCL-90-R demonstrated a statistically significant change from markedly psychological distress to lack of distress after four weeks psychodynamic inpatient psychotherapy (effect-size d(GSI) = 0.82). At the end of psychotherapy, three weeks later, the effect-size was d = 1.11, and one year after discharge the effect-size decreased again to d = 0.85. Major improvements demonstrated the SCL-90-R subscales Depression, Anxiety, and Obsessive/Compulsive. Regarding interpersonal problems, the subscales Dominance, and Competitive demonstrated statistically significant changes from low Stanine-scores at t0 to higher scores one year after discharge. The subscales Socially avoidant, Nonassertive, and Exploitable demonstrated statistical significant changes from high levels at t0 to lower scores after one year. In conclusion the first four weeks of psychodynamic psychotherapy are not sufficient to demonstrate an optimum level of low psychological distress as well as an optimum change in interpersonal problems. Regarding stability of the effects of psychodynamic inpatient psychotherapy it was demonstrated that the first four weeks initiated changes which improved at the end of psychotherapy until one year after discharge.

Persönlichkeitsstörungen nach stationärer psychodynamischer Psychotherapie/ Personality Disorders after Inpatient Psychodynamic Psychotherapy

The following paper presents the results of a post-treatment examination on inpatients with personality disorders who received psychodynamic psychotherapy. The examination was carried out approximately 3.3 years after the patients were discharged. Of a group of 110 patients with personality disorders (ICD-10), 72 patients underwent follow-up examination. A comprehensive catamnesis was compiled for 59 former patients; 13 former patients answered by post. Treatment success was evaluated on the basis of the Symptom Checklist 90-R, Inventory of Interpersonal Problems and Questionnaire of Social Support. These surveys show no significant statistical difference between the data of the subgroups of participants and non-participants of the post-treatment examination at the start and end of therapy (Mann-Whitney-U-Test, p > 0.05). Treatment success was also examined using the Global Assessment of Functioning Scale, the Impairment-Score as well as an analysis of the patient's use of psychiatric and inpatient psychotherapeutic care and the medication received. Due to the reduction in general mental stress and interpersonal problems, and the increase in perceived social support, the patients showed a positive development. After being discharged 41% of the patients received outpatient psychotherapy without further psychiatric and inpatient psychotherapeutic care. The above results demonstrate that patients with personality disorders benefit from inpatient psychodynamic psychotherapy.

Who benefits from inpatient short‐term psychotherapy in the long run? Patients' evaluations, outpatient after‐care and determinants of outcome

Little work has been published on short-term inpatient treatments combining the virtues of inpatient treatments and short-term psychotherapy. The purposes of this study are to (a) determine the outcomes of short-term psychodynamic inpatient psychotherapy from patients' and therapists' perspectives, (b) assess the stability of changes, and (c) identify predictors of long-term outcome. 83 consecutive inpatients (76% of those eligible) were assessed at intake, discharge, and 1 year follow-up by standardized questionnaires regarding symptoms (SCL-90R), interpersonal problems (IIP), object relationships (IPO), and the therapeutic relationship (HAQ). Diagnoses and functioning (GAF) were assessed by the therapists. Psychological distress (effect size S = 1.14) and physical complaints (ES = 1.03) decreased strongly from intake to discharge, the majority of patients moving from the pathological to the normal range of the global severity index GSI (SCL-90R). At follow-up, average distress remained at a low level, and the majority of patients, and their therapists and physicians, regarded their well-being as improved. In a multivariate approach, a substantial proportion of variance of the distress at follow-up (42%) was explained by an infantile object relationship pattern (IPO), social avoidance (IIP), negative vocational changes, and a lack of a confidant at follow-up. A delayed start of subsequent ambulatory psychotherapy was another negative outcome predictor. Attention should be given to maladaptive interpersonal relationship patterns, to vocational reintegration, and a confiding relationship as potential predictors of long-term outcome. Also, patterns of ambulatory after-care following inpatient treatment need further scrutiny.

Entspricht die Symptombesserung vier Wochen nach Behandlungsbeginn dem Erfolg in der Ein-Jahres-Katamnese? - Eine Studie zur stationären psychodynamischen Psychotherapie

Objectives : This study was conducted to explore differentiated aspects of outcome throughout and one year after psychodynamic inpatient psychotherapy with special regard to symptomatic distress and interpersonal behaviour. Methods: Sixty-four patients of the Department of Psychotherapeutic Medicine of the Jerichow Hospital (Saxonia-Anhaltina) were investigated with the SCL-90-R and the IIP-D four times: at the beginning of inpatient psychotherapy (t°), four weeks after (t1), at the end (t2), and one year after discharge (t3). Results: The improvement of symptoms four weeks after the beginning of psycho dynamic inpatient psychotherapy is equivalent with long term outcome. The Global Severity Index of SCL-90-R demonstrated a statistically significant change from mark edly psychological distress to lack of distress after four weeks psychodynamic inpatient psychotherapy (effect-size d(GSI) = 0.82). At the end of psychotherapy, three weeks later, the effect-size was d = 1.11, and one year after discharge the effect-size de creased again to d — 0.85. Major improvements demonstrated the SCL-90-R subscales Depression, Anxiety, and Obsessive/Compulsive. Regarding interpersonal problems, the subscales Dominance, and Competitive demonstrated statistically significant changes from low Stanine-scores at t° to higher scores one year after discharge. The subscales Socially avoidant, Nonassertive, and Exploitable demonstrated statistical significant changes from high levels at t° to lower scores after one year. Discussion: In conclusion the first four weeks of psychodynamic psychotherapy are not sufficient to demonstrate an optimum level of low psychological distress as well as an optimum change in interpersonal problems. Regarding stability of the effects of psychodynamic inpatient psychotherapy it was demonstrated that the first four